Provider Demographics
NPI:1477055168
Name:ELAINE VOZAR ACUPUNCTURIST LTD
Entity Type:Organization
Organization Name:ELAINE VOZAR ACUPUNCTURIST LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:VOZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MSTOM, LICENSED ACUP
Authorized Official - Phone:734-239-5167
Mailing Address - Street 1:2736 W. SUNNYSIDE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625
Mailing Address - Country:US
Mailing Address - Phone:773-609-3711
Mailing Address - Fax:
Practice Address - Street 1:3817 N. PULASKI
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641
Practice Address - Country:US
Practice Address - Phone:773-609-3711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000744171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty